Provider Demographics
NPI:1356332258
Name:CARDIAC CARE CONSULTANTS INC
Entity Type:Organization
Organization Name:CARDIAC CARE CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:CRIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-279-6666
Mailing Address - Street 1:3925 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3649
Mailing Address - Country:US
Mailing Address - Phone:816-279-6666
Mailing Address - Fax:816-279-7363
Practice Address - Street 1:3925 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3649
Practice Address - Country:US
Practice Address - Phone:816-279-6666
Practice Address - Fax:816-279-7363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO14237019OtherBC KC
CH6389OtherRAILROAD MEDICARE
KS0000632671OtherBC KS